Abstract
Objective
Although several cases of thoracic surgery for patients with displaced bronchi have been reported, there are few reports describing the anatomical features of displaced bronchi. The author aimed to analyze the incidence and types of displaced bronchi, and their associated lung lobulations and vascular courses.
Methods
Of 6480 patients who underwent thoracic computed tomography at our hospital from 2012 to 2016, 6072 were included. Displaced bronchi were classified according to their associated lobes and were subclassified based on each lobar or segmental bronchus. Subsequently, the author analyzed the associated abnormalities of lung lobulations and vascular courses.
Results
Of 6072 patients, displaced bronchi were observed in 46 (0.76%): the right upper lobe in 39, the right lower lobe in two, and the left upper lobe in five patients. In the right upper lobe, “Right Upper Lobar Type” was found in six patients “Right B1 Type” in 15, “Right B2 Type” in seven, and “Right B3 Type” in 11 patients. All right lower lobar displaced bronchi were “Right B6 Type” and all left upper lobar displaced bronchi were “Left B1+2 Type”. In the Right B2, Right B3, and Left B1+2 Types, abnormal lung lobulations and top pulmonary veins were frequently noted. All patients with the Right B3 and Left B1+2 Types had unique abnormalities of the pulmonary arteries.
Conclusions
In some types of displaced bronchi, both abnormal lobulations and top pulmonary veins may be useful for recognizing displaced bronchi.
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References
Foster-Carter AF. Broncho-pulmonary abnormalities. Br J Tuberc Dis Chest. 1946;40:111–24.
Ohta S, Saito Y, Usuda K, Kanma K, Sagawa M, Sato M, et al. Tracheobronchal anomalies: report of 71 cases. J Jpn Soc Respir Endosc. 1986;8:122–30 (in Japanese).
Ghaye B, Szapiro D, Fanchamps JM, Dondelinger RF. Congenital bronchial abnormalities revisited. Radiographics. 2001;21:105–19.
Sano A, Yotsumoto T. Right lower lobe superior segmentectomy in a patient with a displaced bronchus. Ann Thorac Surg. 2015;100:e121–2.
Nakamura A, Watanabe S-I, Watanabe Y, Asakura K, Nakagawa K. En bloc upper and lower lobe trisegmentectomy facilitated by displaced segmental airway. Ann Thorac Surg. 2017;104:447–9.
Tajima K, Uchida N, Sasamoto H, Okada T, Kohri T, Mogi A, et al. Lung adenocarcinoma with anomalous bronchi and pulmonary veins preoperatively identified by computed tomography. Thorac Cancer. 2016;7:599–601.
Hayashi K, Motoishi M, Horimoto K, Sawai S, Hanaoka J. Left upper division segmentectomy with a simultaneous displaced bronchus and pulmonary arteriovenous anomalies: a case report. J Cardiothorac Surg. 2018;13:40.
Matsuura N, Go T, Yokota N, Yokomise H. Double-barreled bronchoplasty for a carcinoid tumor with a rare variation of displaced bronchus. J Thorac Dis. 2018;10:E707–9.
Oshiro Y, Murayama S, Ohta M, Teruya T. CT findings of a displaced left upper division bronchus in adults: its importance for performing safe left pulmonary surgery. Eur J Radiol. 2013;82:1347–52.
Yoshimura T, Ueda K-I, Kakinuma A, Nakata Y. Difficulty in placement of a left-sided double-lumen tube due to aberrant tracheobronchial anatomy. J Clin Anesth. 2013;25:413–6.
Evans JA. Aberrant bronchi and cardiovascular anomalies. Am J Med Genet. 1990;35:46–54.
Boyden EA. Developmental anomalies of the lungs. Am J Surg. 1955;89:79–89.
Akiba T, Morikawa T, Inagaki T, Nakada T, Ohki T. A new classification for right top pulmonary vein. Ann Thorac Surg. 2013;95:1227–30.
Asai K, Urabe N, Yajima K. Right upper lobe venous drainage posterior to the bronchus intermedius: preoperative identification by computed tomography. Ann Thorac Surg. 2005;79:1866–71.
Ming Z, Lin Z. Evaluation of tracheal bronchus in Chinese children using multidetector CT. Pediatr Radiol. 2007;37:1230–4.
Chassagnon G, Morel B, Carpentier E, Le Pointe HD, Sirinelli D. Tracheobronchial branching abnormalities: lobe-based classification scheme-erratum. Radiographics. 2016;36:358–73.
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Yaginuma, H. Investigation of displaced bronchi using multidetector computed tomography: associated abnormalities of lung lobulations, pulmonary arteries and veins. Gen Thorac Cardiovasc Surg 68, 342–349 (2020). https://doi.org/10.1007/s11748-019-01223-2
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DOI: https://doi.org/10.1007/s11748-019-01223-2